Abstract
C
Not only have clinical programs of palliative care been established in countries at all levels of development, but also there are academic contributions for the medical research literature. This issue of Journal of Palliative Medicine makes that especially prominent: we have published contributions from North America, South America, Europe, Asia, and Australia in this issue.
Journal of Palliative Medicine has always received articles from around the world. The increase in number and quality is noticeable. In addition, in recent years, we have established relationships with professional associations to assist in dissemination of the information as well as to enhance the journal's ability to publish “leading edge” issues that matter to clinicians caring for patients and their families. One mark of that reach is the number and distribution of those associations: North America, Europe, Asia, and Australia are now represented both on the editorial board and among the associations who have made us an official journal for their association.
Although much is made about cultural diversity, I am more often struck by the similarity of clinical issues faced around the world. For example, the phrase, “daughter from out of town syndrome,” resonates everywhere in the world. The challenges of the family saying “don't tell” when the patient says “tell” are present in every culture. The fear of adverse effects prevents the appropriate use of the opioids for symptom control.
As we finish out our 20th year of publication, I am deeply optimistic about the future of our field. We have moved from being an innovation that struggles to take its place in standard healthcare to a valued element of what we can offer people who are sick and their families. That was the expectation of our publisher when they first invited Dr. David Weissman to be the Founding Editor.
Looking ahead to the next 20 years, there are plenty of new challenges. The foremost issue on everyone's mind is assuring an adequate supply of trained clinicians to provide specialist palliative medicine. There is nowhere on the planet where anyone thinks they have enough currently, let alone for the growth that is projected. A closely related challenge is assuring that all providers have primary palliative care skills so that the specialist palliative care teams can focus on the most difficult cases. Lastly, in a world of limited resources, determining the priority of palliative medicine in relation to other priorities will be debated and negotiated on every continent. In the face of a growing body of new knowledge, there will continue to be a role for Journal of Palliative Medicine publishing the best science that informs the care we should be providing, how we should organize it, and how we should teach it to others.